夫人之常数∶太阳常多血少气，少阳常少血多气，阳明常多气多血，少阴常少血多气，
厥阴
常多血少气，太阴常多气少血，此天之常数。阳明多血多气，刺阳明出血气，太阳多血少气
，刺太阳出血恶气；少阳多气少血，刺少阳出气恶血；太阴多血少气，刺太阴出血恶气；厥
阴多血少气，刺厥阴出血恶气；少阴多气少血，刺少阴出气恶血也。
足阳明五脏六腑之海也，其脉大血多，气盛壮热。刺此者不深弗散，不留不泻也，足阳
明刺
深六分，留十呼。足太阳深五分，留七呼。足少阳深四分，留五呼。足少阴深三分，留四呼
。足太阴深二分，留三呼。足厥阴深一分，留二呼。手之阴阳，其受气之道近，其气之来疾
，其刺深者。皆无过二分，其留皆无过一呼，刺而过此者则脱气。
帝曰∶余闻刺法，有余泻之，不足补之。岐伯曰∶百病之生，皆有虚实，而补泻行焉。
泻虚
补实，神去其室，致邪失正，真不可定，粗之所败，谓之夭命。补虚泻实，神归其室，久塞
其空，谓之良工。凡用针者，随而泻之，迎而道之，虚则实之，满则泻之，菀陈则除之，邪
胜则虚之。徐而疾则实，疾而徐则虚，言实与虚，若有若无。察后与先，若存若亡。为虚与
实，若得若失。虚实之要，九针最妙，补泻之时，以针为之。泻曰必持内之，放而出之，排
阳得针，邪气得泄，按而引针，是谓内温，血不得散，气不得出也。补曰随之，随之之意，
若妄之，若行若按，如蚊虻止，如留如远，去如弦绝，令左属右，其气故止，外门已闭，中
气乃实。必无留血，必取诛之，刺之而气不至，无问其数，刺之而气至，乃去之，勿复针。
针有悬布天下者五，点首共余食，莫之知也。一曰治神，二曰知养身，三曰知毒药，四曰制
砭石大小，五曰知五脏血气之诊。五法俱立，各有所先。今末世之刺也，虚者实也，满者泄
之，此皆众工所共知也。若夫法天则地，随应而动，和之者若响，随之者若影，道无鬼神，
独来独往。帝曰∶愿闻其道。岐伯曰∶凡刺之真，必先治神，五脏已定，九候已备，后乃存
针，众脉不见，众凶弗闻。外内相得，无以形先，可玩往来，乃施于人。人有虚实，五虚勿
近，五实勿远，至其当发，间不容 ，手动若务，针耀而匀，静意视义，观适之变，是谓冥
冥。莫知其形，见其乌乌，见其稷稷，从见其飞，不知其谁。伏如横努，起如发机。刺虚者
须其实，刺实者须其虚。经气已至，慎守勿失，深浅在志，远近若一，如临深渊，手如握虎
，神无营于众物。义无邪下，必正其神。小针之要，易陈而难入。粗守形，上守神，神乎神
，客在门，未睹其疾，恶知其原，刺之微，在速迟。粗守关，上守机，机之动，不离其空，
空中之机，清净而微，其来不可逢，其往不可追，知机之道者，不可挂以发，不知机道叩之
不发。知其往来，要与之期，粗之暗呼！妙哉工独有之，往者为逆，来者为顺，明知逆顺，
正行无间。迎而夺之，恶得无虚，追而济之，恶得无实，迎之随之，以意和之，针道毕矣。
凡用针者，虚则实之，满则泄之，菀陈则除之，邪胜则虚之。大要曰∶徐而疾则实，疾而徐
则虚，言实与虚，若有若无，察后与先，若存若亡，为虚与实，若得若失。虚实之要，九针
最妙，补泻之时，以针为之。泻曰必持内之，放而出之，排阳得针，邪气得泄，按而引针，
是为内温，血不得散气不得出也。补曰随之，随之意若妄之，若行若按，如蚊虻止，如留如
远，去如弦绝，令左属右，其气故止。外门已闭，中气乃实，必无留血，急取诛之。持针之
道，坚者为宝，正指直刺，无针左右，神在秋毫，属意病者，审视血脉者，刺之无殆。方刺
之时，必在悬阳，及与两卫，神属勿去，知病存亡。血脉者在 横居，视之独澄，切之独坚
。刺虚则实之，针下热也，气实乃热也，满而泄之者，针下寒也。菀陈则除之者，出恶血也
。邪盛则虚之者，出针勿按。徐而疾则实者，徐出针而疾按之。疾而徐则虚者，疾出针而徐
按之。言实与虚者，寒温气多少也。若无若有者，疾不可知也。察后与先者，知病先后也。
为虚与实者，工勿失其法。若得若失者，离其法也。虚实之要，九针最妙者，为其各有所宜
也。补泻之时者，与气开阖相合也。九针之名，各不同形者，针穷其所当补泻也。刺实须与
虚者，留针阴气隆至，乃去针也。刺虚须与实者，阳气隆至，针下热，乃去针也，经气已至
，慎守勿失者，勿更改也。浅深在志者，知病之内外也，近远如一者，深浅其候等也。如临
深渊者，不敢坠也，手如握虎者，欲其壮也，神无营于众物者，静志观病患。无左右视也。
义无邪下者，欲端以正也。必正其神者，欲瞻病患，目制其神，令气易行也。所谓易陈者，
易言也。难入者，难着于人也。粗守形者，守刺法也。上守神者，守人之血气有余不足，可
补泻也。神客者，正邪共会也。神者正气也，客者邪气也。在门者，邪循正气之所出入也。
未观其疾者，先知邪正何经之疾也。恶知其原者，先知何经之病所取之处也。刺之微在数迟
者，徐疾之意也。粗守关者，守四肢而不知血气正邪之往来也。上守机者，知守气也。机之
动不离其空者，知气之虚实，用针之徐疾也。空中之极，清净以微者，针以得气，密意守气
勿失也。其来不可逢者，气盛不可补也。其往不可追者，气虚不可泻也。不可挂以发者，言
气易失也。扣之不发者，言不知补泻之意也，血气已尽而气不下也。知其往来者，知气之逆
顺盛虚也。要与之期者，知气之可取之时也。粗之暗者，冥冥不知气之微密也。妙哉工独有
之者，尽知针意也。往者为逆者，言气之虚而小，小者逆也。来者为顺者，言气之平，平者
顺也。明知逆顺，正行无问者，言知所取之处也，逆而夺之者泻也，追而济之者补也。所谓
虚则实之者，气口虚而当补之也。满则泄之者，气口盛而当泻之也。苑陈则除之者，去血脉
也。邪胜则虚之者，言诸经有盛者，皆泻其邪也。徐而疾则实者，言徐内而疾出也，疾而徐
则虚者，言疾内而徐出也。言实与虚，若有若无者，言实者有气，虚者无气也。察后与先，
若无若存者，言气之虚实，补泻之先后也。察其气之已下，与常存也。为虚与实，若得若失
者，言补者必然若有得也，泻则 然若有失也。是故工之用针也，知气之所在，而守其门户
，明于调气，补泻所在。徐疾之意，所取之处，泻必用员。切而转之，其气乃行，疾而徐出
，邪气乃出。伸而逆之，摇大其穴，气出乃疾。补必用方，外引其皮，令当其门，左引其枢
，右推其肤。微旋而徐推之，必端以正，安以静坚，心无解欲，微以留气，下而疾出之，推
其皮盖其外门，神气乃存。用针之要，无忘其神。泻必用方者，以气方盛也，以月方满也。
以日方温也，以身方定也，以息方吸而纳针，及复候其方吸而转针，乃复候其方呼而徐引针
，故曰泻。补必用员者，员者行也，行者移也。刺必中其荣，复以吸排针也，故员与方非针
也。泻实者，气盛乃内针，针与气俱内，以开其门，如利其户，针与气俱出，精气不伤，邪
气乃下，外门不闭，以出其实，摇大其道，如利其路，是谓大泻。必切而出，大气乃屈，持
针叩置，以定其宜，候呼内针，气出针入，针空四塞，精无从出，方实而疾出针，气入针出
，热不得远，闭塞其门，邪气布散，精气乃得存，动气候时。近气不失，远气乃来，是谓追
之。吸则内针，无令气忤。静以久留，无令邪布。吸则转针，以得气为故，候呼引针，呼尽
乃出，大气皆出，故命曰泻。扪而循之，切而散之，推而按之，弹而怒之，爪而下之，通而
取之，外引其门，以闭其神。呼尽内针，静以久留，以气至为故，如待所贵，不知日暮，其
气以至，适而自护，候吸引针气不得出，各在所处，推阖其门，令神气存，大气留止，故命
曰补。补泻弗失，与天地一。经气已至，慎守勿失，浅深在志，远近如一。如临深渊，手如
握虎，神无营于众物。持针之道，欲端以正，安以静，先知虚实而行疾徐。左手执针，右手
循之，无与肉果，泻欲端以正，补必闭肤，转针导气，邪得淫失，真气得居。帝曰∶捍皮开
腠理奈何？岐伯曰∶因其分肉左别其肤，微内而徐端之，适神不散，邪气得去。知其气所在
，先得其道。稀而疏之，稍深以留，故能徐入之。大热在上，推而下之，上者引而去之。视
先痛者，常先取之，大寒在外，留而补之，入于中者，从合泻之。上气不足，推而扬之，下
气不足，积而从之，寒入于中，推而行之。夫实者气入也，虚者气出也，气实者热也，气虚
者寒也。入实者左手开针孔也，入虚者右手闭针孔也。形气不足，病气有余，是邪胜也，急
泻之形气有余。病气不足，急补之形气不足，病气不足，此阴阳俱不足也，不可刺，刺之则
重不足，重不足则阴阳俱竭，血气皆尽，五脏空虚，筋骨髓枯，老者绝灭，壮者不复矣。形
气有余，病气有余，此谓阴阳俱有余也，急泻其邪，调其虚实，故曰有余者泻之，不足者补
之。此之谓也。故曰刺不知逆顺，真邪相搏，满而补之。则阴阳四溢，肠胃充郭，肝肺内
，阴阳相错。虚而泻之，则经脉空虚，血气竭枯，肠胃HT 辟，皮肤薄着，毛腠夭焦，予之死
期。凡用针之类，在于调气。气积于胃，以通荣卫，各行其道。宗气留于海，其下者经于气
冲，其直者走于息道，故厥在于足，宗气不下，脉中之血，流而不止，弗之火调，弗能取之
。散气可收，聚气可布。深居静处，占神往来。闭户塞牍，魂魄不散，专意一神，精气之分
，
毋闻人声，以收其精，必一其神。令志在针，浅而留之，微而浮之，以移其神，气至乃休。
男内女外，坚拒勿出，谨守勿内，是谓得气。刺之而气不至，无问其数。刺之而气至，乃去
之，勿复针。针各有所宜，各不同形，各任其所，为刺之要，气至而有效，效之信，若风之
吹云，明乎若见苍天，刺之道毕矣。用针者，必先察其经络之虚实，切而循之，按而弹之。
视其应动者，乃后取之而下之，六经调者，谓之不病，虽病谓之自已。一经上实下虚而不通
者，此必有横络盛，加于大经令之不通，视而泻之，此所谓解结也。上寒下热，先刺其项太
阳，久留之，已刺则熨项与肩胛，令热下合乃止，此所谓推而上之者也。上热下寒，视其脉
虚而陷下于经者，取之，气下乃止，此所谓引而下之者也。大热篇身狂而妄见妄闻妄语，视
足阳明及大络取之，虚者补之，血而实者泻之，因其偃卧居其头前，以两手四指挟按头动脉
久持之，卷而切推，下至缺盆中而复止如前，热去乃止，此所谓推而散之者也。帝曰∶余闻
刺法，言有余者泻之，不足者补之，何谓有余？何谓不足？岐伯曰∶有余有五，不足亦有五，
帝欲问？帝曰∶愿尽闻之。岐伯曰∶神有余有不足，气有余有不足，血有余有不足，形有余
有不足，志有余有不足，凡此十者，其气不等也。帝曰∶人有精气津液，四支九窍，五脏十
六部，三百六十五节，乃生百病，百病之生，皆有虚实。今夫子乃言有余有五，不足亦有五
，
何以生之乎？岐伯曰∶皆生于五脏也。夫心藏神，肺藏气，肝藏血，脾藏肉，肾藏志，而此
成形，志意通，内连骨髓，而成身形五脏。五脏之道，皆出于经隧，以行血气，血气不和，
百病乃变化而生，是故守经隧焉。帝曰∶神有余不足何如？岐伯曰∶神有余则笑不休，神不
足则悲。血气未并，五脏安定，邪客于形，洒淅起于毫毛未入于经络也，故命曰神之微。帝
曰∶补泻奈何？岐伯曰∶神有余则泻其小络之血，出血勿之深斥，无中其大经，神气乃平。
神不足视其虚络，按而致之，刺而利之，无出其血，无泄其气，以通其经，神气乃平。帝曰
∶刺，微奈何？岐伯曰∶按摩勿释，着针勿斥，移气于不足，神气乃得复。帝曰∶善！气有余
不足奈何？气有余则喘咳上气，不足则息利少气，血气不并。五脏安定，皮肤微病，命曰白
气微泄。帝曰∶补泻奈何？岐伯曰∶气有余则泻其经隧，无伤其经，无出其血，无泄其气。
不足则补其经隧，无出其气。帝曰∶刺微奈何？岐伯曰∶按摩勿释，出针视之，曰我将深之
，适人必革，精气自伏，邪气散乱，无所休息，气泄腠理，真气乃相得。帝曰∶善，血有余
不足奈何？岐伯曰∶血有余则怒，不足则恐，血气未并，五脏安定，孙络水溢，则经有流血
。帝曰∶补泻奈何？岐伯曰∶血有余则泻其盛经，出其血。不足则视其虚经，针其脉中，久
留而视脉大疾，出其针，无令血泄。帝曰∶刺留血奈何？岐伯曰∶视其血络，刺出其血，无
令恶血得入于经，以成其疾。帝曰∶善！形有余不足奈何？岐伯曰∶形有余则腹胀，泾溲不利
人的生理常数如下：太阳经通常多血少气，少阳经通常少血多气，阳明经通常多气多血，少阴经通常少血多气，厥阴经通常多血少气，太阴经通常多气少血，这是与生俱来的恒定规律。阳明经多气多血，针刺阳明经可使其出血和气；太阳经多血少气，针刺太阳经可使其出血而避免耗气；少阳经多气少血，针刺少阳经可使其出气而避免耗血；太阴经多气少血，针刺太阴经可使其出血而避免耗气；厥阴经多血少气，针刺厥阴经可使其出血而避免耗气；少阴经多气少血，针刺少阴经可使其出气而避免耗血。
足阳明胃经是五脏六腑气血的海源，其脉管大、血液多，气盛且壮热。针刺此处如果不深刺则气不散，如果不留针则邪不泻。足阳明经针刺深度为六分，留针十次呼吸的时间。足太阳膀胱经深五分，留针七次呼吸。足少阳胆经深四分，留针五次呼吸。足少阴肾经深三分，留针四次呼吸。足太阴脾经深二分，留针三次呼吸。足厥阴肝经深一分，留针两次呼吸。手部的阴阳经脉，其受气的途径较近，气来势疾速，所以针刺深度都不得超过二分，留针时间都不得超过一次呼吸，如果超过这个限度就会导致气脱。
黄帝说：我听说针刺法则，有余的要用泻法，不足的要用补法。岐伯说：各种疾病的发生，都有虚实之分，因此施行补泻治疗。如果虚证用泻法、实证用补法，就会使神气离失，招致邪气，丧失正气，真气无法安定，这是粗劣医生造成的败坏，称为夭折命运。如果是虚证用补法、实证用泻法，就能使神气回归，长久地充实空虚之处，这称为高明的医生。凡是使用针的人，要顺着经气方向而泻之，迎着经气方向而导之，虚证用实法（补），实证用泻法，满溢则泻之，郁结陈旧者去除之，邪气胜则使之虚。慢进快出为补，快进慢出为泻，谈论虚实，好像有又好像没有。观察治疗的先后顺序，好像存在又好像消失。处理虚实，好像得到又好像失去。虚实的关键，九针最为奇妙，补泻的时机，依靠针具来实现。泻法必须持针插入，放出并拔出，推开皮肤得针，使邪气得泄，按压并引出针，这叫内温，血不得散，气不得出。补法是跟随经气，跟随的意思，好像若无其事，又像行走又像按压，像蚊虻叮咬停留，又像离开又像久远，拔针时像弓弦断裂一样迅速，使左手属右，经气自然停止，外门已闭，中气乃实。必须不留瘀血，如有瘀血必取而诛除。针刺后经气未至，不要问次数多少；针刺后经气已至，就停止针刺，不要再扎。针具有五种悬布天下的法则，但点头共余食（注：此处原文可能有误或指代不明，通常解为世人不知），没有人知道。一是治神，二是知养身，三是知毒药，四是制砭石大小，五是知五脏血气之诊。这五种方法都确立后，各有其优先次序。如今末世的针刺，虚证反而用实法，实证反而用泻法，这些都是众工匠所共同知道的错误。至于效法天地，随应而动，调和者如回声相应，跟随者如影子相随，道中没有鬼神，独自往来。黄帝说：希望听听这个道理。岐伯说：凡针刺的真谛，必先治神，五脏定好，九候备齐，然后才存心于针，不见杂乱之脉，不听杂乱之声。内外相得，不以形体为先，可以玩味经气的往来，然后施用于人。人有虚实，五虚勿近，五实勿远，到了该发针的时候，间隙不容，手动专注，针光亮而均匀，静心观察义理，观看适应的变化，这叫冥冥之中，不知道它的形状，看见它乌乌聚集，看见它稷稷众多，从看见它飞动，不知道是谁。伏藏时如横弩待发，兴起时如发射机关。刺虚证须使其实，刺实证须使其虚。经气已至，谨慎守护不要丢失，深浅在于心意，远近如一，如同面临深渊，手如握虎，心神不被众物扰乱。义理不正不下针，必须端正其神。小针的要领，容易陈述却难深入。粗工守形，上工守神。神妙啊神妙，客邪在门户，没看到疾病，怎么知道根源？针刺的精微，在于速迟。粗工守关节，上工守气机。气机的变动，不离空窍，空窍中的气机，清净而细微，气盛不可逢迎（补），气虚不可追随（泻）。懂得气机之道的人，不会因毫发之差而失误，不懂气机之道的人，叩之不发。知道气的往来，要与它约定时机，粗工是暗昧的！妙哉只有工匠独有。往者为逆，来者为顺，明知逆顺，正行无间隔。迎着而夺之，怎么能不虚？追着而济之，怎么能不实？迎着跟着，以意调和，针道至此完毕。凡是使用针的人，虚则实之，满则泄之，菀陈则除之，邪胜则虚之。大要说：慢进快出为实（补），快进慢出为虚（泻），谈论虚实，若有若无，观察先后，若存若亡，处理虚实，若得若失。虚实的关键，九针最妙，补泻之时，以针为之。泻法曰必须持针插入，放出并拔出，推开皮肤得针，邪气得泄，按压并引针，是为内温，血不得散，气不得出。补法曰随之，随之之意若妄之，若行若按，如蚊虻止，如留如远，去如弦绝，令左属右，其气故止，外门已闭，中气乃实，必无留血，急取诛之。持针之道，坚者为宝，正指直刺，无针左右，神在秋毫，属意病者，审视血脉者，刺之无殆。方刺之时，必在悬阳，及与两卫，神属勿去，知病存亡。血脉者在横居，视之独澄，切之独坚。刺虚则实之，针下热也，气实乃热也，满而泄之者，针下寒也。菀陈则除之者，出恶血也。邪盛则虚之者，出针勿按。徐而疾则实者，徐出针而疾按之。疾而徐则虚者，疾出针而徐按之。言实与虚者，寒温气多少也。若无若有者，疾不可知也。察后与先者，知病先后也。为虚与实者，工勿失其法。若得若失者，离其法也。虚实之要，九针最妙者，为其各有所宜也。补泻之时者，与气开阖相合也。九针之名，各不同形者，针穷其所当补泻也。刺实须与虚者，留针阴气隆至，乃去针也。刺虚须与实者，阳气隆至，针下热，乃去针也，经气已至，慎守勿失者，勿更改也。浅深在志者，知病之内外也，近远如一者，深浅其候等也。如临深渊者，不敢坠也，手如握虎者，欲其壮也，神无营于众物者，静志观病患。无左右视也。义无邪下者，欲端以正也。必正其神者，欲瞻病患，目制其神，令气易行也。所谓易陈者，易言也。难入者，难着于人也。粗守形者，守刺法也。上守神者，守人之血气有余不足，可补泻也。神客者，正邪共会也。神者正气也，客者邪气也。在门者，邪循正气之所出入也。未观其疾者，先知邪正何经之疾也。恶知其原者，先知何经之病所取之处也。刺之微在数迟者，徐疾之意也。粗守关者，守四肢而不知血气正邪之往来也。上守机者，知守气也。机之动不离其空者，知气之虚实，用针之徐疾也。空中之极，清净以微者，针以得气，密意守气勿失也。其来不可逢者，气盛不可补也。其往不可追者，气虚不可泻也。不可挂以发者，言气易失也。扣之不发者，言不知补泻之意也，血气已尽而气不下也。知其往来者，知气之逆顺盛虚也。要与之期者，知气之可取之时也。粗之暗者，冥冥不知气之微密也。妙哉工独有之者，尽知针意也。往者为逆者，言气之虚而小，小者逆也。来者为顺者，言气之平，平者顺也。明知逆顺，正行无问者，言知所取之处也，逆而夺之者泻也，追而济之者补也。所谓虚则实之者，气口虚而当补之也。满则泄之者，气口盛而当泻之也。苑陈则除之者，去血脉也。邪胜则虚之者，言诸经有盛者，皆泻其邪也。徐而疾则实者，言徐内而疾出也，疾而徐则虚者，言疾内而徐出也。言实与虚，若有若无者，言实者有气，虚者无气也。察后与先，若无若存者，言气之虚实，补泻之先后也。察其气之已下，与常存也。为虚与实，若得若失者，言补者必然若有得也，泻则 然若有失也。是故工之用针也，知气之所在，而守其门户，明于调气，补泻所在。徐疾之意，所取之处，泻必用员。切而转之，其气乃行，疾而徐出，邪气乃出。伸而逆之，摇大其穴，气出乃疾。补必用方，外引其皮，令当其门，左引其枢，右推其肤。微旋而徐推之，必端以正，安以静坚，心无解欲，微以留气，下而疾出之，推其皮盖其外门，神气乃存。用针之要，无忘其神。泻必用方者，以气方盛也，以月方满也。以日方温也，以身方定也，以息方吸而纳针，及复候其方吸而转针，乃复候其方呼而徐引针，故曰泻。补必用员者，员者行也，行者移也。刺必中其荣，复以吸排针也，故员与方非针也。泻实者，气盛乃内针，针与气俱内，以开其门，如利其户，针与气俱出，精气不伤，邪气乃下，外门不闭，以出其实，摇大其道，如利其路，是谓大泻。必切而出，大气乃屈，持针叩置，以定其宜，候呼内针，气出针入，针空四塞，精无从出，方实而疾出针，气入针出，热不得远，闭塞其门，邪气布散，精气乃得存，动气候时。近气不失，远气乃来，是谓追之。吸则内针，无令气忤。静以久留，无令邪布。吸则转针，以得气为故，候呼引针，呼尽乃出，大气皆出，故命曰泻。扪而循之，切而散之，推而按之，弹而怒之，爪而下之，通而取之，外引其门，以闭其神。呼尽内针，静以久留，以气至为故，如待所贵，不知日暮，其气以至，适而自护，候吸引针气不得出，各在所处，推阖其门，令神气存，大气留止，故命曰补。补泻弗失，与天地一。经气已至，慎守勿失，浅深在志，远近如一。如临深渊，手如握虎，神无营于众物。持针之道，欲端以正，安以静，先知虚实而行疾徐。左手执针，右手循之，无与肉果，泻欲端以正，补必闭肤，转针导气，邪得淫失，真气得居。帝曰：捍皮开腠理奈何？岐伯曰：因其分肉左别其肤，微内而徐端之，适神不散，邪气得去。知其气所在，先得其道。稀而疏之，稍深以留，故能徐入之。大热在上，推而下之，上者引而去之。视先痛者，常先取之，大寒在外，留而补之，入于中者，从合泻之。上气不足，推而扬之，下气不足，积而从之，寒入于中，推而行之。夫实者气入也，虚者气出也，气实者热也，气虚者寒也。入实者左手开针孔也，入虚者右手闭针孔也。形气不足，病气有余，是邪胜也，急泻之形气有余。病气不足，急补之形气不足，病气不足，此阴阳俱不足也，不可刺，刺之则重不足，重不足则阴阳俱竭，血气皆尽，五脏空虚，筋骨髓枯，老者绝灭，壮者不复矣。形气有余，病气有余，此谓阴阳俱有余也，急泻其邪，调其虚实，故曰有余者泻之，不足者补之。此之谓也。故曰刺不知逆顺，真邪相搏，满而补之。则阴阳四溢，肠胃充郭，肝肺内 ，阴阳相错。虚而泻之，则经脉空虚，血气竭枯，肠胃HT 辟，皮肤薄着，毛腠夭焦，予之死期。凡用针之类，在于调气。气积于胃，以通荣卫，各行其道。宗气留于海，其下者经于气冲，其直者走于息道，故厥在于足，宗气不下，脉中之血，流而不止，弗之火调，弗能取之。散气可收，聚气可布。深居静处，占神往来。闭户塞牍，魂魄不散，专意一神，精气之分，毋闻人声，以收其精，必一其神。令志在针，浅而留之，微而浮之，以移其神，气至乃休。男内女外，坚拒勿出，谨守勿内，是谓得气。刺之而气不至，无问其数。刺之而气至，乃去之，勿复针。针各有所宜，各不同形，各任其所，为刺之要，气至而有效，效之信，若风之吹云，明乎若见苍天，刺之道毕矣。用针者，必先察其经络之虚实，切而循之，按而弹之。视其应动者，乃后取之而下之，六经调者，谓之不病，虽病谓之自已。一经上实下虚而不通者，此必有横络盛，加于大经令之不通，视而泻之，此所谓解结也。上寒下热，先刺其项太阳，久留之，已刺则熨项与肩胛，令热下合乃止，此所谓推而上之者也。上热下寒，视其脉虚而陷下于经者，取之，气下乃止，此所谓引而下之者也。大热篇身狂而妄见妄闻妄语，视足阳明及大络取之，虚者补之，血而实者泻之，因其偃卧居其头前，以两手四指挟按头动脉久持之，卷而切推，下至缺盆中而复止如前，热去乃止，此所谓推而散之者也。帝曰：余闻刺法，言有余者泻之，不足者补之，何谓有余？何谓不足？岐伯曰：有余有五，不足亦有五，帝欲问？帝曰：愿尽闻之。岐伯曰：神有余有不足，气有余有不足，血有余有不足，形有余有不足，志有余有不足，凡此十者，其气不等也。帝曰：人有精气津液，四支九窍，五脏十六部，三百六十五节，乃生百病，百病之生，皆有虚实。今夫子乃言有余有五，不足亦有五，何以生之乎？岐伯曰：皆生于五脏也。夫心藏神，肺藏气，肝藏血，脾藏肉，肾藏志，而此成形，志意通，内连骨髓，而成身形五脏。五脏之道，皆出于经隧，以行血气，血气不和，百病乃变化而生，是故守经隧焉。帝曰：神有余不足何如？岐伯曰：神有余则笑不休，神不足则悲。血气未并，五脏安定，邪客于形，洒淅起于毫毛未入于经络也，故命曰神之微。帝曰：补泻奈何？岐伯曰：神有余则泻其小络之血，出血勿之深斥，无中其大经，神气乃平。神不足视其虚络，按而致之，刺而利之，无出其血，无泄其气，以通其经，神气乃平。帝曰：刺，微奈何？岐伯曰：按摩勿释，着针勿斥，移气于不足，神气乃得复。帝曰：善！气有余不足奈何？气有余则喘咳上气，不足则息利少气，血气不并。五脏安定，皮肤微病，命曰白气微泄。帝曰：补泻奈何？岐伯曰：气有余则泻其经隧，无伤其经，无出其血，无泄其气。不足则补其经隧，无出其气。帝曰：刺微奈何？岐伯曰：按摩勿释，出针视之，曰我将深之，适人必革，精气自伏，邪气散乱，无所休息，气泄腠理，真气乃相得。帝曰：善，血有余不足奈何？岐伯曰：血有余则怒，不足则恐，血气未并，五脏安定，孙络水溢，则经有流血。帝曰：补泻奈何？岐伯曰：血有余则泻其盛经，出其血。不足则视其虚经，针其脉中，久留而视脉大疾，出其针，无令血泄。帝曰：刺留血奈何？岐伯曰：视其血络，刺出其血，无令恶血得入于经，以成其疾。帝曰：善！形有余不足奈何？岐伯曰：形有余则腹胀，泾溲不利
The constant physiological norms of humans are as follows: The Taiyang (Greater Yang) channel typically has abundant blood and deficient qi, the Shaoyang (Lesser Yang) channel typically has deficient blood and abundant qi, the Yangming (Yang Brightness) channel typically has abundant qi and abundant blood, the Shaoyin (Lesser Yin) channel typically has deficient blood and abundant qi, the Jueyin (Terminal Yin) channel typically has abundant blood and deficient qi, and the Taiyin (Greater Yin) channel typically has abundant qi and deficient blood. These are the natural constants. Regarding the Yangming channel, which has abundant qi and blood, needling may cause both blood and qi to be discharged; for the Taiyang channel, which has abundant blood and deficient qi, needling should discharge blood but avoid discharging qi; for the Shaoyang channel, which has abundant qi and deficient blood, needling should discharge qi but avoid discharging blood; for the Taiyin channel, which has abundant qi and deficient blood, needling should discharge blood but avoid discharging qi; for the Jueyin channel, which has abundant blood and deficient qi, needling should discharge blood but avoid discharging qi; and for the Shaoyin channel, which has abundant qi and deficient blood, needling should discharge qi but avoid discharging blood.
The Foot-Yangming Stomach Channel is the sea of the five zang organs and six fu organs; its vessels are large, blood is abundant, and qi is vigorous with strong heat. When needling this area, if not inserted deeply enough, the qi will not disperse; if not retained long enough, the pathogenic factor will not be drained. For the Foot-Yangming channel, the insertion depth is six fen, with retention for ten breaths. For the Foot-Taiyang Bladder Channel, the depth is five fen, retained for seven breaths. For the Foot-Shaoyang Gallbladder Channel, the depth is four fen, retained for five breaths. For the Foot-Shaoyin Kidney Channel, the depth is three fen, retained for four breaths. For the Foot-Taiyin Spleen Channel, the depth is two fen, retained for three breaths. For the Foot-Jueyin Liver Channel, the depth is one fen, retained for two breaths. For the hand yin and yang channels, the pathway for receiving qi is proximate, and the arrival of qi is rapid; therefore, the maximum insertion depth should not exceed two fen, and the maximum retention time should not exceed one breath. If these limits are exceeded, it will lead to qi depletion.
The Yellow Emperor said: I have heard that in needling techniques, excess conditions are treated by draining (Xie), and deficiency conditions are treated by reinforcing (Bu). Qibo replied: The onset of all diseases involves either excess or deficiency, thus necessitating the application of reinforcing and draining methods. Draining deficiency and reinforcing excess causes the Shen (Spirit) to leave its chamber, inviting pathogens and causing loss of righteousness; the true qi becomes unstable, leading to ruin by incompetent practitioners, termed premature death. Conversely, reinforcing deficiency and draining excess allows the Shen to return to its chamber and permanently fills the void, characterizing a skilled artisan. In using needles, one should drain by following the flow of qi, guide by opposing the flow, treat deficiency with reality (reinforcement), treat fullness with drainage, remove stagnation and old blood, and reduce excess pathogens. Slow insertion and quick withdrawal reinforce (Shi); quick insertion and slow withdrawal drain (Xu). Discussing excess and deficiency appears as if present and absent. Observing sequence and priority seems like existence and non-existence. Managing deficiency and excess feels like gaining and losing. The key to deficiency and excess lies in the Nine Needles, which are most excellent; the timing of reinforcement and drainage is achieved through the needle. To drain, one must hold and insert the needle, release and withdraw it, push aside the skin to admit the needle, allowing pathogenic qi to escape, then press and draw out the needle, creating internal warmth so that blood does not scatter and qi does not escape. To reinforce, one follows the qi; the intention is as if nonexistent, moving or pressing lightly, like a mosquito or horsefly landing, lingering yet distant, withdrawing quickly like a snapping bowstring, coordinating left and right, stopping the qi naturally, closing the external gate, and filling the central qi. One must ensure no residual blood remains; if present, it must be purged. If qi does not arrive after needling, do not count the number of inserts; if qi arrives, stop and do not re-needle. There are five principles of needling disseminated under heaven, yet few understand them: first, regulating the Shen; second, knowing how to nourish the body; third, understanding toxic drugs; fourth, sizing calami (stone needles); fifth, diagnosing the qi and blood of the five zang organs. With these five methods established, each has its precedence. In modern times, practitioners mistakenly reinforce deficiency and drain excess, a common error among artisans. However, those who follow the laws of heaven and earth, responding dynamically, harmonize like echoes and follow like shadows. The Dao operates without ghosts or gods, coming and going alone. The Yellow Emperor asked to hear this Dao. Qibo replied: The essence of needling requires first regulating the Shen. Once the five zang organs are stabilized and the nine pulses are prepared, one focuses on the needle, ignoring chaotic pulses and sounds. External and internal factors must align; do not rely solely on physical form. Understand the movement of qi before applying treatment. Recognize deficiency and excess; avoid treating severe deficiency (Five Deficiencies) and severe excess (Five Excesses). When the moment for needling arrives, act swiftly. Handle the needle with focus, keeping it bright and even. Observe silently, watching for adaptation. This state is called "Mingming" (obscure/subtle). Its form is unseen, yet one sees it gathering ("Wuwu") and abundant ("Jiji"), flying yet unidentifiable. It hides like a drawn crossbow and rises like a released trigger. Treating deficiency requires achieving fullness; treating excess requires achieving emptiness. Once Jing Qi (Meridian Qi) arrives, guard it carefully without loss. Depth and distance are determined by intent, remaining consistent. Approach with caution like standing at an abyss; handle the needle firmly like holding a tiger; keep the Shen focused, undistracted by external objects. Do not insert obliquely; correct the Shen. The essentials of small needles are easy to describe but hard to master. Incompetent practitioners focus on form; superior practitioners focus on Shen. Shen is subtle; the pathogen resides at the gate. Before seeing the disease, how can one know its origin? The subtlety of needling lies in speed and slowness. Incompetent practitioners guard joints; superior practitioners guard the Qi mechanism. The movement of the mechanism stays within the acupoint (Kong). The Qi within the acupoint is pure, clear, and subtle. When Qi is abundant, do not reinforce (meet it); when Qi is deficient, do not drain (chase it). Those who understand the Dao of Qi do not miss by a hair's breadth; those who do not understand fail to elicit a response even when prompted. Knowing the direction of Qi allows one to time the intervention correctly; incompetence is characterized by ignorance. Marvelous indeed, only skilled artisans possess this knowledge. "Going" represents reversal (Ni); "Coming" represents smoothness (Shun). Knowing reversal and smoothness allows precise action without deviation. Opposing and seizing drains; chasing and assisting reinforces. Following and opposing, harmonized by intent, completes the Dao of needling. Generally, treat deficiency by reinforcing, fullness by draining, stagnation by removing, and excess pathogens by reducing. The general principle states: Slow insertion and quick withdrawal reinforce; quick insertion and slow withdrawal drain. Discussing excess and deficiency appears as if present and absent. Observing sequence and priority seems like existence and non-existence. Managing deficiency and excess feels like gaining and losing. The key to deficiency and excess lies in the Nine Needles, which are most excellent because each is suitable for specific conditions. The timing of reinforcement and drainage corresponds with the opening and closing of Qi. The Nine Needles differ in shape because they target different aspects of supplementation and drainage. To treat excess requiring reduction, retain the needle until Yin Qi arrives abundantly, then remove it. To treat deficiency requiring reinforcement, retain the needle until Yang Qi arrives abundantly and the needle feels warm, then remove it. Once Jing Qi arrives, guard it carefully without changing technique. Depth depends on knowing the interior/exterior location; consistency in depth reflects equal observation. Approaching with caution like standing at an abyss prevents falling; handling firmly like holding a tiger ensures strength; keeping Shen undistracted means focusing quietly on the patient. Inserting correctly requires uprightness; correcting the Shen involves observing the patient's eyes to control their spirit and facilitate Qi flow. "Easy to describe" refers to simple speech; "hard to enter" refers to difficulty in application. Incompetent practitioners guard form (technique); superior practitioners guard Shen (vitality/Qi-Blood balance). "Shen Ke" refers to the meeting of righteous and pathogenic Qi. Shen is righteous Qi; Ke is pathogenic Qi. "At the gate" means the pathogen enters/exits along the path of righteous Qi. Before observing the disease, one must first know which meridian is affected. Knowing the origin means knowing where to select points. The subtlety of needling lies in speed/slowness. Incompetent practitioners guard limbs, unaware of Qi-Blood dynamics; superior practitioners guard Qi. The mechanism's movement relies on the acupoint, indicating Qi deficiency/excess and determining needle speed. The acupoint's purity and subtlety require careful guarding of Qi once obtained. "Cannot meet abundance" means do not reinforce when Qi is excessive; "cannot chase deficiency" means do not drain when Qi is deficient. "Not missing by a hair" emphasizes the fragility of Qi; "prompting without response" indicates ignorance of reinforcement/drainage intentions, where Qi-Blood is exhausted and Qi fails to descend. Knowing Qi's direction allows timing the intervention. Incompetence is ignorance of Qi's subtleties. Skill lies in mastering needle intent. "Going/Ni" implies deficient/small Qi; "Coming/Shun" implies balanced/smooth Qi. Knowing reversal and smoothness guides point selection. Opposing drains; chasing reinforces. "Reinforce deficiency" means tonifying a deficient pulse; "Drain fullness" means reducing a full pulse. "Remove stagnation" means clearing blood vessels; "Reduce excess pathogens" means draining all meridians with excess. "Slow in/quick out" reinforces; "Quick in/slow out" drains. "Excess has Qi, deficiency lacks Qi." "Observing sequence" refers to the order of Qi deficiency/excess and treatment. "Gaining/Losing" describes the sensation of successful reinforcement (feeling gained) versus drainage (feeling lost). Thus, skilled practitioners locate Qi, guard the gate, regulate Qi, and determine reinforcement/drainage sites. For draining, use round movements: press and rotate to move Qi, withdraw quickly and slowly to expel pathogens, extend and oppose, enlarge the aperture, and allow rapid Qi exit. For reinforcing, use square movements: pull skin to align with the gate, guide with left hand, push with right, rotate slightly and push slowly, maintaining uprightness and stillness. Keep the mind free from distraction, retain Qi slightly, withdraw quickly, push skin to close the gate, preserving Shen Qi. The essence of needling is never forgetting the Shen. Draining uses "Fang" (Square) when Qi is abundant, moon is full, day is warm, body is stable, and during inhalation: insert during inhalation, rotate during inhalation, withdraw slowly during exhalation. Reinforcing uses "Yuan" (Round/Moving): penetration reaches Ying (Nutrient) level, withdrawing during inhalation. "Round" and "Square" refer to techniques, not needle shapes. To drain excess: insert when Qi is abundant, entering with Qi to open the gate like a door, exiting with Qi to preserve essence and expel pathogens without closing the external gate, enlarging the path for major drainage. Press upon withdrawal to subdue strong Qi. Hold and place the needle calmly. Insert during exhalation (Qi out, needle in), sealing the needle space so essence cannot escape. Withdraw quickly while Qi enters, closing the gate to prevent heat loss, dispersing pathogens and preserving essence. Timing movement with Qi brings nearby Qi and attracts distant Qi, termed "Chasing." Insert during inhalation to avoid Qi conflict. Retain quietly to prevent pathogen spread. Rotate during inhalation until Qi arrives. Withdraw during exhalation, emptying large amounts of Qi, termed "Draining." Palpate, rub, press, tap, and scratch to open the gate and close the Shen. Insert at end of exhalation, retain until Qi arrives, guarding like waiting for a noble. When Qi arrives, protect it appropriately. Withdraw during inhalation to trap Qi, closing the gate to store Shen Qi, termed "Reinforcing." Adhering to reinforcement/drainage aligns with Heaven and Earth. Guard Jing Qi once arrived; maintain depth/distance consistency; approach cautiously; handle firmly; keep Shen focused. Hold the needle upright and calm; determine deficiency/excess before acting. Left hand holds, right hand guides; avoid flesh resistance. Drain with uprightness; reinforce by closing skin. Rotate to guide Qi, expelling pathogens and securing true Qi. The Yellow Emperor asked about separating skin and opening pores. Qibo replied: Separate skin along muscle intervals, insert slightly and slowly uprightly, ensuring Shen remains undisturbed so pathogens depart. Knowing Qi location, find the method first. Needle sparsely and deeply for retention, allowing slow entry. For upper heat, push downward; for upper heat, draw away. Treat painful areas first. For exterior cold, retain and reinforce; for interior cold, drain via He-Sea points. For insufficient upper Qi, push and raise; for insufficient lower Qi, accumulate and follow; for cold in interior, push and circulate. Excess involves Qi entering; deficiency involves Qi leaving. Excess is hot; deficiency is cold. For entering excess, open the needle hole with the left hand; for entering deficiency, close the needle hole with the right hand. If Form-Qi is deficient but Pathogenic-Qi is excess, it is pathogenic victory; urgently drain. If Form-Qi is excess but Pathogenic-Qi is deficient, urgently reinforce. If both Form-Qi and Pathogenic-Qi are deficient, both Yin and Yang are depleted; do not needle, as this causes double deficiency, exhausting Yin/Yang, Blood/Qi, emptying five zang organs, drying sinews/marrow/bone, leading to death in the elderly and irreversibility in the strong. If both Form-Qi and Pathogenic-Qi are excess, both Yin and Yang are surplus; urgently drain pathogens and regulate deficiency/excess. Thus, "excess is drained, deficiency is reinforced." If one needles without knowing reversal/smoothness, true and pathogenic Qi clash. Reinforcing excess causes Yin/Yang to overflow, intestines/stomach to distend, liver/lungs to compress, and Yin/Yang to disorder. Draining deficiency causes meridians to empty, Blood/Qi to枯竭, intestines/stomach to collapse, skin to thin, hair/pores to wither, and death to ensue. All needling aims to regulate Qi. Qi accumulates in the stomach to nourish Ying and Wei, traveling their respective paths. Zong Qi (Pectoral Qi) remains in the Sea (Chest); descending parts pass through Qichong; straight parts travel the respiratory tract. Thus, Jue (reversal/cold) in feet occurs when Zong Qi fails to descend, causing blood in vessels to flow endlessly. Without fire regulation, it cannot be treated. Scattered Qi can be gathered; aggregated Qi can be distributed. Dwelling quietly, observe Shen's movement. Close doors, gather Hun and Po, focus on one Shen, divide Jing Qi, ignore human voices, collect essence, unify Shen. Direct intent to the needle. Insert shallowly and retain; float slightly to shift Shen; rest when Qi arrives. For men, retain internally; for women, retain externally; firmly reject exit, guard against entry; this is obtaining Qi. If Qi does not arrive, ignore counts; if Qi arrives, stop and do not re-needle. Needles vary in suitability and shape, serving specific needs. The essence of needling is efficacy upon Qi arrival. Efficacy is confirmed like wind blowing clouds away, revealing blue sky. The Dao of needling is complete. Practitioners must first examine meridian deficiency/excess, palpate, rub, press, and tap. Observe reactions before selecting points. If six meridians are harmonious, there is no disease, or recovery occurs. If one meridian has upper excess/lower deficiency with blockage, likely due to transverse collaterals obstructing main meridians, visualize and drain to untie knots. For upper cold/lower heat, needle Neck-Taiyang, retain long, apply heat to neck/shoulders until heat descends, termed "Pushing Upward." For upper heat/lower cold, select deficient/depressed points, lower Qi, then stop, termed "Drawing Downward." For high fever with mania/hallucinations, examine Foot-Yangming and major collaterals; reinforce deficiency, drain blood excess. Have patient lie supine, press head arteries with four fingers, roll and push down to Quepen, repeat until heat subsides, termed "Pushing and Dispersing." The Yellow Emperor asked about excess/deficiency definitions. Qibo listed five excesses and five deficiencies arising from five zang organs: Heart stores Shen, Lungs store Qi, Liver stores Blood, Spleen stores Flesh, Kidneys store Zhi. These form the body and connect to marrow. Five zang pathways emerge from meridians to circulate Blood/Qi; disharmony causes disease. Therefore, guard the meridians. For Shen excess, laughter is unceasing; for Shen deficiency, sadness prevails. If Blood/Qi are not mixed and zang organs are stable, pathogen affects form superficially (Haomaotao), termed "Subtle Shen Disease." To treat Shen excess, drain small collaterals' blood without deep pressure or damaging major meridians. For Shen deficiency, view deficient collaterals, press to gather Qi, needle to benefit without bleeding or leaking Qi, unblocking meridians to restore Shen. For subtle Shen disease, massage without releasing, needle without pushing, transferring Qi to deficiency to restore Shen. For Qi excess, panting/coughing/upward Qi; for Qi deficiency, clear breathing but shortness of breath. Skin mildly affected, termed "White Qi Micro-Leak." To treat Qi excess, drain meridian tunnels without damaging meridians, bleeding, or leaking Qi. For Qi deficiency, reinforce meridian tunnels without leaking Qi. For subtle Qi disease, massage without releasing, withdraw needle and observe, pretending deep insertion to settle essence, scatter pathogens, leak Qi through pores, restoring True Qi. For Blood excess, anger; for Blood deficiency, fear. If Blood/Qi not mixed, sun-collaterals overflow, causing major vessel bleeding. To treat Blood excess, drain full meridians and bleed. For Blood deficiency, view deficient meridians, needle pulse, retain long, watch pulse enlarge, withdraw quickly without bleeding. For retained blood, view blood collaterals, needle to bleed, preventing evil blood from entering meridians. For Form excess, abdominal distension, difficult urination/defecation...